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Acetaminophen use in pregnancy linked to child's behavioral problems

latimes.com

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Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#61

Post by Broken_Hippo »

MichaelGG wrote: post #52
rabboRubble wrote: post #46

Earlier quoted context omitted.

The reason I am freaked about acetaminophen is that I suffer from migraines. The most effective OTC medicine for me is Excedrin Migraine (a combo of acetaminophen, aspirin, and caffeine). I didn’t realize that this med contained acetaminophen. I also didn’t realize that the product name Tylenol equaled acetaminophen. Only put things together when I heard about people overdosing and examined my medicine cabinet and ch…

Why are you medicating with anything without looking at what it is? Read label. If not understood, quickly look up the medications involved. Unless they are marketed very misleadingly (possible - opiates get tons of bad press, Tylenol doesn't), seems like you have zero reason to complain. You voluntarily consumed medications without even reading through the basic info that's on the box! Splitting into two pills? Why…

I worked in a pharmacy (not a pharmacist), and this sort of thing is extremely common. I helped a nicely dressed fellow one night, who asked where the Advil was. I showed him, and pointed out the store brand (Much cheaper). The guy told me that ibuprofin doesn't work for him, only Advil. This happens with the cough and cold medicines as well - most are the same combination of drugs, sometimes with or without one, and folks will buy different labeled combinations at different times.

When the word got out about tylenol and liver damage, one of the causes they cited was the same situation as above - multiple drug compounds. Migraines. Folks thinking tylenol was the safe choice, impossible to overdose on. Folks generally think the stuff on the shelf is really, really safe.

It isn't like they teach this stuff in school. While I might have known to look out, I didn't always know this. And if this sort of information misses you when it was the 'big news'... well, out of luck.

I'd much rather the products be in different pills most of the time as I think it means consumers might think a bit more about what they take and match it up with symptoms. Either that, or have many be only available without receipt after asking pharmacist or trained personel.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#62

Post by pjc50 »

rand_r wrote: post #55
fifteenforty wrote: post #34

Anaesthesia trainee here (doctor, similar to an anesthesiology resident in US vocabulary) I've read the actual referenced paper and not the LA times piece. This type of research is hypothesis generating. As they acknowledge, this shows a correlation, not causation. The big question here is why were these women taking paracetamol/acetaminophen? Was it the drug or the cause of their pain/fever/discomfort that is more r…

Given how taxing these types of drugs are, why are opiates not an option for most people? They don't cause any long or short-term damage to organs.

Fears about addiction, and a huge dispute over how well-founded those fears are.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#63

Post by pjc50 »

pessimizer wrote: post #14

What an unnecessary, garbage drug; one that's responsible for half the liver failures in the United States. Maybe a restriction on pregnant women taking it could move it behind the counter, or better, into the dimly-remembered past.

Behind the counter, yes, but it's too useful to take away entirely and the politics of pain management medication are a mess.

(In the UK, you can buy it OTC but only in regulated small pack sizes, as it used to be the most common drug used in attempted suicide-by-overdose.)

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#64

Post by k-mcgrady »

kirrent wrote: post #54
k-mcgrady wrote: post #37

Earlier quoted context omitted.

Regarding your comment on liver failure: wouldn't you need to take more than the allowed dose for this to happen?

You do. The interesting thing about paracetamol is that toxicity arises at only about 3 times the maximum daily recommended dose. For a drug which is perceived as so safe it's common for someone to continue downing them when they're in pain and become quite sick. Certainly a problem of education, not the drug itself.

It surprises me people would just 'down' any medication. I've always stuck strictly to the very clear instructions on the box (I believe it's 2 every 4 hours, no more than 8 within 24 hours for paracetomol) and everyone I know does. Reading through this thread though it seems like a lot of people seem to be confident enough to play doctor and decide what they should/shouldn't take and what is good/bad for them. Maybe it's a cultural thing but everyone I know is pretty careful with even 'staple' medications like this or NSAID's.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#65

Post by fifteenforty »

rand_r wrote: post #55
fifteenforty wrote: post #34

Anaesthesia trainee here (doctor, similar to an anesthesiology resident in US vocabulary) I've read the actual referenced paper and not the LA times piece. This type of research is hypothesis generating. As they acknowledge, this shows a correlation, not causation. The big question here is why were these women taking paracetamol/acetaminophen? Was it the drug or the cause of their pain/fever/discomfort that is more r…

Given how taxing these types of drugs are, why are opiates not an option for most people? They don't cause any long or short-term damage to organs.

Without careful prescription and monitoring, they are certainly more dangerous than the so-called "simple" analgesics (paracetamol/acetaminophen and the NSAIDs). Each year there are many deaths related to prescription opioids[1] and they do result in long-term damage.

Some commenters here seem to like codeine. It should be considered at least as dangerous as morphine (which it is metabolised to). Depending on your genetic background, you may poorly metabolise codeine (causing it to be ineffective), or you may metabolise codeine too effectively (causing it to cause respiratory depression, low oxygen levels and possibly death). The tide is gradually moving against it[2], but not quickly enough in my opinion.

With all pain, the safest treatments don't involve drugs.

[1] http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6450a3.htm [2] http://www.nps.org.au/publications/health-professional/healt...

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#66

Post by m_eiman »

emn13 wrote: post #56
fifteenforty wrote: post #34

Anaesthesia trainee here (doctor, similar to an anesthesiology resident in US vocabulary) I've read the actual referenced paper and not the LA times piece. This type of research is hypothesis generating. As they acknowledge, this shows a correlation, not causation. The big question here is why were these women taking paracetamol/acetaminophen? Was it the drug or the cause of their pain/fever/discomfort that is more r…

Also, what they're correlating is memory of paracetamol usage, not actual usage. I'm not sure I remember if I used paracetamol the past 3 months. It may well be that more severe pain (or other) symptoms are more easily remembered, so that their "paracetamol" usage is actually correlated with severity of symptoms, and not entirely with actual usage. Frankly, I think the summary in that article is a little irresponsibl…

what they're correlating is memory of paracetamol usage, not actual usage.

According to the article:

"Finally, the authors of the study acted to avoid a common problem with research that links adverse pregnancy outcomes to certain medications: that women whose children have some identifiable problem are more likely to recall taking medications during pregnancy. The current study asked women when they were pregnant about their medication use, and then — seven years after her child’s birth — asked her to assess her child’s emotional and social well-being and report a range of problematic behaviors."

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#67

Post by 300bps »

rabboRubble wrote: post #46
marpstar wrote: post #36

Earlier quoted context omitted.

I never take acetaminophen anymore and generally only take ibuprofen, and only a few times a year. Serious question: Why do people even take acetaminophen anymore?

The reason I am freaked about acetaminophen is that I suffer from migraines. The most effective OTC medicine for me is Excedrin Migraine (a combo of acetaminophen, aspirin, and caffeine). I didn’t realize that this med contained acetaminophen. I also didn’t realize that the product name Tylenol equaled acetaminophen. Only put things together when I heard about people overdosing and examined my medicine cabinet and ch…

One thing I was surprised to learn is that Excedrin Migraine is identical to regular Excedrin. It's just marketed differently.

There are different formulations of Excedrin (ex: Migraine Tension has no aspirin) but the Migraine formula is identical to the regular formula.

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#68

Post by erdevs »

fifteenforty wrote: post #34

Anaesthesia trainee here (doctor, similar to an anesthesiology resident in US vocabulary) I've read the actual referenced paper and not the LA times piece. This type of research is hypothesis generating. As they acknowledge, this shows a correlation, not causation. The big question here is why were these women taking paracetamol/acetaminophen? Was it the drug or the cause of their pain/fever/discomfort that is more r…

Supposing this study is further replicated and one wished to avoid paracetamol during pregnancy, what alternatives for pain relief would be recommended?

Re: Acetaminophen use in pregnancy linked to child's behavioral problems

#69

Post by mafro »

300bps wrote: post #67
rabboRubble wrote: post #46

Earlier quoted context omitted.

The reason I am freaked about acetaminophen is that I suffer from migraines. The most effective OTC medicine for me is Excedrin Migraine (a combo of acetaminophen, aspirin, and caffeine). I didn’t realize that this med contained acetaminophen. I also didn’t realize that the product name Tylenol equaled acetaminophen. Only put things together when I heard about people overdosing and examined my medicine cabinet and ch…

One thing I was surprised to learn is that Excedrin Migraine is identical to regular Excedrin. It's just marketed differently. There are different formulations of Excedrin (ex: Migraine Tension has no aspirin) but the Migraine formula is identical to the regular formula.

Nurofen's owner got into trouble over this in Australia recently:

https://www.theguardian.com/business/2015/dec/14/nurofens-ma...

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